Anderson Stephen, Gopi-Firth Shridevi
Consultant Psychiatrist in Eating Disorders, NHS Greater Glasgow and Clyde, UK.
Speciality Doctor in Eating Disorders, NHS Forth Valley, UK.
Br Dent J. 2023 Mar;234(6):445-449. doi: 10.1038/s41415-023-5619-x. Epub 2023 Mar 24.
Although primarily classified as psychiatric disorders, eating disorders have a complex aetiology and presentation, with comorbidities spanning multiple disciplines, including dental complications. In some cases, general dental practitioners may be the first health professional to become aware that someone is struggling with an eating disorder. The dental team is in an ideal position to sensitively explore the presentation and signpost the patient to appropriate services while offering support and/or remedial management for dental complications of the eating disorder. Anyone from any background, gender or ethnicity may develop an eating disorder, of which the main diagnoses are anorexia nervosa, bulimia nervosa and binge eating disorder. Some of the frequently seen oral manifestations of these disorders include generalised dental erosion, caries, self-inflicted palatal or oropharyngeal trauma, atrophic mucosa, bilateral parotid gland enlargement, xerostomia and periodontal disease. The dentist's role is pivotal in recognising the possible implications of some of these findings, approaching the patient sensitively, and communicating empathetically to engage them in treatment, reducing the risk of further erosion and improving oral health and hygiene. The dental team may be able to signpost the patient to their general practitioner for onward referral or to a local eating disorder support network.
尽管饮食失调主要归类为精神疾病，但其病因和表现复杂，合并症涉及多个学科，包括牙科并发症。在某些情况下，普通牙科医生可能是首个意识到有人正在与饮食失调作斗争的医疗专业人员。牙科团队处于理想位置，能够敏感地探究症状表现，并为患者指明合适的服务途径，同时为饮食失调引发的牙科并发症提供支持和/或补救治疗。任何背景、性别或种族的人都可能患上饮食失调症，其主要诊断类型为神经性厌食症、神经性贪食症和暴饮暴食症。这些病症一些常见的口腔表现包括广泛性牙齿侵蚀、龋齿、自我造成的腭部或口咽创伤、萎缩性黏膜、双侧腮腺肿大、口干症和牙周病。牙医在认识到其中某些症状可能产生的影响、以敏感方式接触患者以及进行富有同理心的沟通以使他们参与治疗方面发挥着关键作用，从而降低进一步侵蚀的风险并改善口腔健康和卫生状况。牙科团队或许能够为患者指明去找其全科医生以便进一步转诊，或指向当地的饮食失调支持网络。
